Provider First Line Business Practice Location Address:
11 CHURCH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREEBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-374-0100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2014